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Younes S, Samara M, Salama N, Al-jurf R, Nasrallah G, Al-Obaidly S, Salama H, Olukade T, Hammuda S, Abdoh G, Abdulrouf PV, Farrell T, AlQubaisi M, Al Rifai H, Al-Dewik N. Incidence, risk factors, and feto-maternal outcomes of inappropriate birth weight for gestational age among singleton live births in Qatar: A population-based study. PLoS One 2021; 16:e0258967. [PMID: 34710154 PMCID: PMC8553085 DOI: 10.1371/journal.pone.0258967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 10/09/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Abnormal fetal growth can be associated with factors during pregnancy and at postpartum. OBJECTIVE In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes associated with small-for-gestational age (SGA) and large-for-gestational age (LGA) infants. METHODS We performed a population-based retrospective study on 14,641 singleton live births registered in the PEARL-Peristat Study between April 2017 and March 2018 in Qatar. We estimated the incidence and examined the risk factors and outcomes using univariate and multivariate analysis. RESULTS SGA and LGA incidence rates were 6.0% and 15.6%, respectively. In-hospital mortality among SGA and LGA infants was 2.5% and 0.3%, respectively, while for NICU admission or death in labor room and operation theatre was 28.9% and 14.9% respectively. Preterm babies were more likely to be born SGA (aRR, 2.31; 95% CI, 1.45-3.57) but male infants (aRR, 0.57; 95% CI, 0.4-0.81), those born to parous (aRR 0.66; 95% CI, 0.45-0.93), or overweight (aRR, 0.64; 95% CI, 0.42-0.97) mothers were less likely to be born SGA. On the other hand, males (aRR, 1.82; 95% CI, 1.49-2.19), infants born to parous mothers (aRR 2.16; 95% CI, 1.63-2.82), or to mothers with gestational diabetes mellitus (aRR 1.36; 95% CI, 1.11-1.66), or pre-gestational diabetes mellitus (aRR 2.58; 95% CI, 1.8-3.47) were significantly more likely to be LGA. SGA infants were at high risk of in-hospital mortality (aRR, 226.56; 95% CI, 3.47-318.22), neonatal intensive care unit admission or death in labor room or operation theatre (aRR, 2.14 (1.36-3.22). CONCLUSION Monitoring should be coordinated to alleviate the risks of inappropriate fetal growth and the associated adverse consequences.
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Affiliation(s)
- Salma Younes
- Department of Research, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Muthanna Samara
- Department of Psychology, Kingston University London, Kingston upon Thames, United Kingdom
| | - Noor Salama
- Health Profession Awareness Program, Health Facilities Development, Hamad Medical Corporation (HMC), Doha, Qatar
- American University in Cairo (AUC), Cairo, Egypt
| | - Rana Al-jurf
- College of Health and Life Science (CHLS), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Gheyath Nasrallah
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Sawsan Al-Obaidly
- Obstetrics and Gynecology Department, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Husam Salama
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Tawa Olukade
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Sara Hammuda
- Department of Psychology, Kingston University London, Kingston upon Thames, United Kingdom
| | - Ghassan Abdoh
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Palli Valapila Abdulrouf
- Department of Research, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
- Department of Pharmacy, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Thomas Farrell
- Department of Research, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
- Obstetrics and Gynecology Department, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Mai AlQubaisi
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Hilal Al Rifai
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Nader Al-Dewik
- College of Health and Life Science (CHLS), Hamad Bin Khalifa University (HBKU), Doha, Qatar
- Interim Translational Research Institute (iTRI), Hamad Medical Corporation (HMC), Doha, Qatar
- Faculty of Health and Social Care Sciences, Kingston University, St. George’s University of London, London, United Kingdom
- Department of Pediatrics, Clinical and Metabolic Genetics, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
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Kawasaki M, Mito A, Waguri M, Sato Y, Abe E, Shimada M, Fukuda S, Sasaki Y, Fujikawa K, Sugiyama T, Ota E, Nakazawa J, Okoshi T, Takimoto H, Honda Y, Inoue E, Hiramatsu Y, Arata N. Protocol for an interventional study to reduce postpartum weight retention in obese mothers using the internet of things and a mobile application: a randomized controlled trial (SpringMom). BMC Pregnancy Childbirth 2021; 21:582. [PMID: 34425784 PMCID: PMC8381573 DOI: 10.1186/s12884-021-03998-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obese pregnant women are known to experience poorer pregnancy outcomes and are at higher risk of postnatal arteriosclerosis. Hence, weight control during and after pregnancy is important for reducing these risks. The objective of our planned randomized controlled trial is to evaluate whether the rate of change in body weight in obese women before pregnancy to 12 months postpartum would be lower with the use of an intervention consisting of Internet of Things (IoT) devices and mobile applications during pregnancy to 1 year postpartum compared to a non-intervention group. METHODS Women will be recruited during outpatient maternity checkups at four perinatal care institutions in Japan. We will recruit women at less than 30 weeks of gestation with a pre-pregnancy body mass index ≥ 25 kg/m2. The women will be randomly assigned to an intervention or non-intervention group. The intervention will involve using data (weight, body composition, activity, sleep) measured with IoT devices (weight and body composition monitor, activity, and sleep tracker), meal records, and photographs acquired using a mobile application to automatically generate advice, alongside the use of a mobile application to provide articles and videos related to obesity and pregnancy. The primary outcome will be the ratio of change in body weight (%) from pre-pregnancy to 12 months postpartum compared to before pregnancy. DISCUSSION This study will examine whether behavioral changes occurring during pregnancy, a period that provides a good opportunity to reexamine one's habits, lead to lifestyle improvements during the busy postpartum period. We aim to determine whether a lifestyle intervention that is initiated during pregnancy can suppress weight gain during pregnancy and encourage weight loss after delivery. TRIAL REGISTRATION UMIN: UMIN (University hospital Medical Information Network) 000,041,460. Resisted on 18th August 2020. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047278.
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Affiliation(s)
- Maki Kawasaki
- Department of Health Policy, National Center for Child Health and Development, 2-10-1, OkuraTokyo, Setagaya, 157-8535, Japan.,Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, 2-10-1, OkuraTokyo, Setagaya, 157-8535, Japan
| | - Asako Mito
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, 2-10-1, OkuraTokyo, Setagaya, 157-8535, Japan
| | - Masako Waguri
- Department of Obstetric Medicine, Osaka Women's and Children's Hospital, Murodo-cho, Izumi, Osaka, 840594-1101, Japan
| | - Yuichi Sato
- Obstetrics & Gynecology, TATE DEBARI Sato Hospital, 96, Wakamatsu-cho, Takasaki, Gunma, 370-0836, Japan
| | - Emiko Abe
- Department of Obstetrics and Gynecology, Ehime Prefectural Central Hospital, 83, Matusyama City, Ehime, Kasuga-cho, 790-0024, Japan
| | - Mayumi Shimada
- Department of Obstetric Medicine, Osaka Women's and Children's Hospital, Murodo-cho, Izumi, Osaka, 840594-1101, Japan
| | - Sayuri Fukuda
- Obstetrics & Gynecology, TATE DEBARI Sato Hospital, 96, Wakamatsu-cho, Takasaki, Gunma, 370-0836, Japan
| | - Yuki Sasaki
- Link and Communication Inc, 4-1, Kioi-cho, Chiyoda, Tokyo, 102-0094, Japan
| | - Kei Fujikawa
- Department of Obstetric Medicine, Osaka Women's and Children's Hospital, Murodo-cho, Izumi, Osaka, 840594-1101, Japan
| | - Takashi Sugiyama
- Department of Obsterics and Gynecology, Ehime Uiversity Graduate School of Medicine, Touon City, Ehime, Sitsukawa, 454791-0295, Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing Sciences, St. Lukes International University, 10-1, Akashi-cho, Tyuuou, Tokyo, 1104-0044, Japan
| | - Jin Nakazawa
- Faculty of Environment and Information Studies, Keio University, Fujisawa City, Kanagawa, Endo, 5322252-0882, Japan
| | - Tadashi Okoshi
- Graduate School of Media and Governance, Fujisawa City, Kanagawa, Endo, 5322252-0882, Japan
| | - Hidemi Takimoto
- National Institute of Health and Nutrition, 23-1, Toyama, Shinjuku, Tokyo, 162-8636, Japan
| | - Yuka Honda
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, 2-10-1, OkuraTokyo, Setagaya, 157-8535, Japan
| | - Eisuke Inoue
- Showa University Research Administration Center, Showa University, 1-5-8, Hatanodai, ShinagawaTokyo, 142-8555, Japan
| | - Yuji Hiramatsu
- Okayama City General Medical Center, 3-20-1, KitanagaseomotemachiOkayama City, Okayama, 700-8557, Japan
| | - Naoko Arata
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, 2-10-1, OkuraTokyo, Setagaya, 157-8535, Japan.
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Chuang YC, Huang L, Lee WY, Shaw SW, Chu FL, Hung TH. The association between weight gain at different stages of pregnancy and risk of gestational diabetes mellitus. J Diabetes Investig 2021; 13:359-366. [PMID: 34415679 PMCID: PMC8847131 DOI: 10.1111/jdi.13648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/02/2021] [Accepted: 08/17/2021] [Indexed: 12/14/2022] Open
Abstract
AIMS/INTRODUCTION Women with excessive gestational weight gain (GWG) are at a higher risk for complications during pregnancy, such as preeclampsia. However, the association between excessive GWG and gestational diabetes mellitus (GDM) remains unclear. MATERIALS AND METHODS We retrospectively reviewed 8,352 women from our obstetric database with singleton pregnancies who gave birth after 28 completed weeks of gestation between January 1, 2012, and December 31, 2016, excluding pregnancies complicated by fetal anomalies, fetal death, and overt diabetes. Diagnosis of GDM was based on the criteria recommended by the International Association of Diabetes and Pregnancy Study Groups. We used two classification methods to define excessive GWG: a weight gain above the 90th percentile of the population, or exceeding the upper range recommended by the Institute of Medicine, stratified by pre-pregnancy body mass index. Statistical analysis was performed using multiple logistic regression to determine the association between excessive GWG and the risk of GDM. RESULTS Overall, 1,129 women (13.5%) were diagnosed with GDM. There was no difference in GWG between women with and without GDM in the first trimester and before GDM screening. Women with GDM had significantly less GWG in the second trimester, after GDM screening, and throughout the whole gestation than women without GDM. No correlation was found between excessive GWG in the first and second trimesters, before GDM screening, and the later development of GDM. CONCLUSIONS Our results indicate that excessive GWG prior to GDM screening is not associated with an increased risk of GDM.
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Affiliation(s)
- Ya-Chun Chuang
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Lulu Huang
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Wan-Ying Lee
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Steven W Shaw
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Fu-Ling Chu
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,Department of Medical Nutrition Therapy, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tai-Ho Hung
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Liang CC, Chao M, Chang SD, Chiu SYH. Impact of prepregnancy body mass index on pregnancy outcomes, incidence of urinary incontinence and quality of life during pregnancy - An observational cohort study. Biomed J 2020; 43:476-483. [PMID: 33246799 PMCID: PMC7804172 DOI: 10.1016/j.bj.2019.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 10/17/2019] [Accepted: 11/07/2019] [Indexed: 01/01/2023] Open
Abstract
Background To evaluate the effects of prepregnancy body mass index (BMI) on pregnancy outcomes, prevalence of urinary incontinence, and quality of life. Methods The observational cohort included 2210 pregnant women who were divided into 4 groups according to their prepregnancy BMI: underweight (<18.5), normal weight (18.5–24.9), overweight (25–29.9), and obese (≥30). Data were analyzed for pregnancy outcomes, prevalence of urinary incontinence during pregnancy, scores of the Short Form 12 health survey (SF-12) and changes in sexual function. Results Compared with normal weight, overweight and obesity were associated with advanced maternal age, low education level, multiparity, preterm delivery, cesarean section, gestational weight gain above the Institute of Medicine (IOM) guidelines, preeclampsia, gestational diabetes, macrosomia and large fetal head circumference. After adjusting for confounding factors, women with overweight and obesity were more likely to have adverse maternal outcomes (gestational weight gain above the IOM guidelines, preeclampsia and gestational diabetes) and fetal outcomes (large fetal head circumference and macrosomia) compared to normal weight women. Overweight and obese women (BMI ≥ 25) were more likely to have urinary incontinence than normal weight and underweight women. There were no significant differences in SF-12 scores among the 4 BMI groups, but more than 90% of pregnant women had reduced or no sexual activities regardless of BMI. Conclusions Maternal prepregnancy overweight and obesity are associated with greater risks of preeclampsia, gestational diabetes, macrosomia and urinary incontinence. Health care providers should inform women to start their pregnancy at a BMI in the normal weight category.
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Affiliation(s)
- Ching-Chung Liang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan
| | - Minston Chao
- Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan
| | - Shuenn-Dhy Chang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Sherry Yueh-Hsia Chiu
- Department of Health Care Management and Healthy Aging Research Center, College of Management, Chang Gung University, Taoyuan, Taiwan; Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
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Gou BH, Guan HM, Bi YX, Ding BJ. Gestational diabetes: weight gain during pregnancy and its relationship to pregnancy outcomes. Chin Med J (Engl) 2019; 132:154-160. [PMID: 30614859 PMCID: PMC6365271 DOI: 10.1097/cm9.0000000000000036] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Weight gain during pregnancy reflects the mother's nutritional status. However, it may be affected by nutritional therapy and exercise interventions used to control blood sugar in gestational diabetes mellitus (GDM). This study aimed to evaluate weight gain during gestation and pregnancy outcomes among women with GDM. METHODS A retrospective study involving 1523 women with GDM was conducted between July 2013 and July 2016. Demographic data, gestational weight gain (GWG), blood glucose, glycated-hemoglobin level, and maternal and fetal outcomes were extracted from medical records. Relationships between GWG and pregnancy outcomes were investigated using multivariate logistic regression. RESULTS In total, 451 (29.6%) women showed insufficient GWG and 484 (31.8%) showed excessive GWG. Excessive GWG was independently associated with macrosomia (adjusted odds ratio [aOR] 2.20, 95% confidence interval [CI] 1.50-3.52, P < 0.001), large for gestational age (aOR 2.06, 95% CI 1.44-2.93, P < 0.001), small for gestational age (aOR 0.49, 95% CI 0.25-0.97, P = 0.040), neonatal hypoglycemia (aOR 3.80, 95% CI 1.20-12.00, P = 0.023), preterm birth (aOR 0.45, 95% CI 0.21-0.96, P = 0.040), and cesarean delivery (aOR 1.45, 95% CI 1.13-1.87, P = 0.004). Insufficient GWG increased the incidence of preterm birth (aOR 3.53, 95% CI 1.96-6.37, P < 0.001). CONCLUSIONS Both excessive and insufficient weight gain require attention in women with GDM. Nutritional therapy and exercise interventions to control blood glucose should also be used to control reasonable weight gain during pregnancy to decrease adverse pregnancy outcomes.
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Affiliation(s)
- Bao-Hua Gou
- Department of Gynaecology and Obstetrics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Hui-Min Guan
- Department of Gynaecology and Obstetrics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Yan-Xia Bi
- Department of Clinical Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Bing-Jie Ding
- Department of Clinical Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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Lassek WD, Gaulin SJC. Do the Low WHRs and BMIs Judged Most Attractive Indicate Higher Fertility? EVOLUTIONARY PSYCHOLOGY 2018; 16:1474704918800063. [PMID: 30296846 PMCID: PMC10480809 DOI: 10.1177/1474704918800063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 08/20/2018] [Indexed: 12/30/2022] Open
Abstract
We examine the widely accepted view that very low waist-hip ratios and low body mass indices (BMIs) in women in well-nourished populations are judged attractive by men because these features reliably indicate superior fertility. In both subsistence and well-nourished populations, relevant studies of fertility do not support this view. Rather studies indicate lower fertility in women with anthropometric values associated with high attractiveness. Moreover, low maternal BMI predisposes to conditions that compromise infant survival. Consistent with these findings from the literature, new data from a large U.S. sample of women past reproductive age show that women with lower BMIs in the late teens had fewer live births, controlling for education, marital history, and race. They also had later menarche and earlier menopause compared with women with higher youth BMIs. In addition, data from the 2013 U.S. natality database show that mothers with lower prepregnancy BMIs have an increased risk of producing both low-birth-weight and preterm infants controlling for other relevant variables-conditions that would have adversely affected fitness over almost all of human evolution. Thus, a review of the relevant literature and three new tests fail to support the view that highly attractive women are more fertile.
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Affiliation(s)
- William D. Lassek
- Department of Anthropology, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Steven J. C. Gaulin
- Department of Anthropology, University of California at Santa Barbara, Santa Barbara, CA, USA
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Hirooka-Nakama J, Enomoto K, Sakamaki K, Kurasawa K, Miyagi E, Aoki S. Optimal weight gain in obese and overweight pregnant Japanese women. Endocr J 2018; 65:557-567. [PMID: 29563351 DOI: 10.1507/endocrj.ej18-0027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We aimed to determine the optimal gestational weight gain (GWG) in Japanese women with a Body Mass Index (BMI) ≥25 kg/m2. The present retrospective study investigated singleton pregnancies in 6,781 Japanese women registered in the Japan Society of Obstetrics and Gynecology system in 2013. We divided overweight and obese women into four GWG categories based on the Institute of Medicine (IOM) recommended: weight loss, small weight gain, within IOM criteria, and above IOM criteria. The adjusted odds ratios and predicted probabilities of maternal and neonatal outcomes of interest with weight change were calculated. In overweight women, GWG was associated with neonatal birth weight. In the loss and small gain subgroups, there was a significant increase in small for gestational age (SGA) and low birth weight neonates (LBW). Predicted probabilities showed the lowest risk was observed in a weight gain of 0 kg; the risk sharply increased at a gain of 11.5 kg. In obese women, weight gain increased the prevalence of large for gestational age (LGA) neonates; however; SGA was not associated with GWG. Predicted probabilities showed an increase in the risk with weight gain. The observed optimal GWG was 0 to 11.5 kg in overweight, and weight loss in obese, pregnant Japanese women.
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Affiliation(s)
- Junko Hirooka-Nakama
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Kimiko Enomoto
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Kentaro Sakamaki
- Department of Biostatistics and Epidemiology, Yokohama City University Graduate School of Medicine and University Medical Center, Yokohama, Kanagawa, Japan
| | - Kentaro Kurasawa
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
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Chen YH, Tao FB, Xu DX. THE ASSOCIATION BETWEEN PREPREGNANCY BODY MASS INDEX AND RISK OF PRETERM DELIVERY IN A CHINESE POPULATION. Am J Epidemiol 2018; 187:1123-1124. [PMID: 29390047 DOI: 10.1093/aje/kwy016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 01/22/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Yuan-Hua Chen
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, China
- Department of Histology and Embryology, School of Basic Medical Science, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Fang-Biao Tao
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - De-Xiang Xu
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
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9
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Zhao R, Xu L, Wu M, Huang S, Cao X. Maternal pre-pregnancy body mass index, gestational weight gain influence birth weight. Women Birth 2018; 31:e20-e25. [DOI: 10.1016/j.wombi.2017.06.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 06/04/2017] [Accepted: 06/06/2017] [Indexed: 02/06/2023]
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10
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An X, Zhao Y, Zhang Y, Yang Q, Wang Y, Cheng W, Yang Z. Risk assessment of morbidly obese parturient in cesarean section delivery: A prospective, cohort, single-center study. Medicine (Baltimore) 2017; 96:e8265. [PMID: 29049219 PMCID: PMC5662385 DOI: 10.1097/md.0000000000008265] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Up to 40% of women gain excessive weight during pregnancy. Obesity complications and risks in parturient women undergoing cesarean section (CS) with different anesthetic methods remain unknown. This study aimed to assess the safety and risk of obese women undergoing CS delivery with various perioperative anesthetic methods. METHODS Seven hundred ninety parturient women underwent CS under general anesthesia (GA), intraspinal anesthesia including epidural anesthesia (EA) and combined spinal-epidural anesthesia (CSEA). They were divided into morbid (n = 255), severe (n = 274), and non-obesity (n = 261) groups. This study is registered with ClinicalTrials.gov (number NCT03002636). RESULT Between 2013 and 2016, 790 pregnant were assessed. Compared with the non-obesity group, there were significantly more fetal distress and higher body mass index (BMI) in the morbid obesity group (P = .0001 and P = .001, respectively). Significantly more patients showed preeclampsia, multifetation, amniotic fluid abnormality, and high bleeding amounts in the morbid obesity group compared with the non-obesity group (P = .0001, P = .048, P = .017, and P = .018, respectively); more patients were administered EA and GA compared with the non-obesity group (P = .0001 and P = .0001, respectively). More post-anesthesia care unit (PACU) patients were found in the severe obesity group no more than the non-obesity group. Significantly increased anesthesia puncture times for 5 > n ≥ 3 and n ≥ 5 were obtained in the morbid obesity group (P = .0001 and P = .0001, respectively), with more patients in the puncture sitting position, compared with the non-obesity group (P = .0001). CONCLUSION GA, EA, and CSEA are safe and effective in severely or morbidly obese patients. Morbidly obese parturient show increased likelihood for fetal distress, PACU, sitting position puncture, puncture difficulty, and other pregnancy complications. There were more anesthesia puncture times in morbidly obese patients.
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Affiliation(s)
| | | | | | | | | | - Weiwei Cheng
- Department of Gynaecology and Obstetrics, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
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Kaimura M, Oda M, Mitsubuchi H, Ohba T, Katoh T. Participant Characteristics in the Kumamoto University Regional Center of Japan Environment and Children's Study (JECS): Association of Pregnancy Outcomes with Pregestational Maternal Body Mass Index and Maternal Weight Gain during Pregnancy. Nihon Eiseigaku Zasshi 2017; 72:128-134. [PMID: 28552893 DOI: 10.1265/jjh.72.128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to identify participant characteristics in the Kumamoto University Regional Center of the Japan Environment and Children's Study (K-JECS) and to investigate the association of pregnancy outcomes with pregestational maternal body mass index (BMI) and maternal weight gain during pregnancy (MWG). METHODS The subjects were women with singleton birth, who had been recruited by the K-JECS, and were registered in the data systems for the first and second questionnaires and transcripts of medical records. The subjects were categorized by BMI with further classification by MWG. The chi-squared test and one-way analysis of variance were performed to determine the correlations of BMI and MWG with perinatal outcomes. Logistic regression analysis was performed to examine perinatal outcome risks. RESULTS The subject characteristics were similar to the trends observed in the Japanese general population. The odds ratio for natural delivery was low in the overweight groups (OW) and normal weight groups (NW) with excessive weight gain. On the other hand, the risk of cesarean section was high in the OW, and risk of induced or accelerated delivery was high in the NW with excessive weight gain. The risks of preterm birth and LBW were high in the insufficient weight gain groups regardless of BMI. The risks of pregnancy-induced hypertension and gestational diabetes were high in the OW.
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Affiliation(s)
- Michiko Kaimura
- Kumamoto University Regional Center, The Japan Environment and Children's Study (JECS)
| | - Masako Oda
- Kumamoto University Regional Center, The Japan Environment and Children's Study (JECS)
| | - Hiroshi Mitsubuchi
- Kumamoto University Regional Center, The Japan Environment and Children's Study (JECS).,Department of Neonatology, Kumamoto University Hospital
| | - Takashi Ohba
- Kumamoto University Regional Center, The Japan Environment and Children's Study (JECS).,Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University
| | - Takahiko Katoh
- Kumamoto University Regional Center, The Japan Environment and Children's Study (JECS).,Department of Public Health, Faculty of Life Sciences, Kumamoto University
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Gao X, Yan Y, Xiang S, Zeng G, Liu S, Sha T, He Q, Li H, Tan S, Chen C, Li L, Yan Q. The mutual effect of pre-pregnancy body mass index, waist circumference and gestational weight gain on obesity-related adverse pregnancy outcomes: A birth cohort study. PLoS One 2017; 12:e0177418. [PMID: 28575041 PMCID: PMC5456032 DOI: 10.1371/journal.pone.0177418] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/26/2017] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine the mutual effect of pre-pregnancy body mass index (BMI), waist circumference (WC) and gestational weight gain (GWG) on obesity-related adverse pregnancy outcomes. METHODS This birth cohort study was conducted in three Streets in Changsha, China, including a total of 976 mother-child pairs. All data was collected within 15 days after deliveries from a self-administered questionnaire, maternal health manual and perinatal health care information system. Multivariate logistic regression models were conducted to estimate the effects of maternal pre-pregnancy BMI, WC and GWG on obesity-related adverse pregnancy outcomes including gestational diabetes mellitus (GDM), primary cesarean section (P-CS), large for gestational age (LGA) and composite outcome (one or more adverse pregnancy outcomes). RESULTS After controlling for all confounders, both maternal pre-pregnancy overweight/obesity and central adiposity contributed to increased risks of GDM [ORs 95% CIs = 2.19 (1.02-4.76) and 2.26 (1.11-4.60), respectively], P-CS [ORs 95% CIs = 1.66 (1.05-2.65) and 1.71 (1.11-2.63), respectively], LGA [ORs 95% CIs = 1.93 (1.07-3.50) and 2.14 (1.21-3.75), respectively] and composite outcome [ORs 95% CIs = 1.82 (1.15-2.87) and 1.98 (1.30-3.01), respectively] compared with mothers with normal pre-pregnancy weight and normal WC. Excessive GWG was found to be associated with an increased risk of LGA [OR 95% CI = 1.74 (1.05-2.89)], but was not significantly related to higher risks of GDM, P-CS and composite outcome [ORs 95% CIs = 0.90 (0.47-1.72), 1.08 (0.77-1.52), and 1.30 (0.94-1.79), respectively]. In terms of the joint effect of maternal pregestational BMI and WC on obesity-related composite outcome, mothers with both pre-pregnancy overweight and central adiposity had the highest risk of composite outcome [OR 95% CI = 3.96 (2.40-6.54)], compared with mothers without pre-pregnancy overweight or central adiposity. CONCLUSIONS The results of this study suggest that maternal pre-pregnancy overweight/obesity and central adiposity may contribute to multiple obesity-related adverse pregnancy outcomes, excessive weight gain during pregnancy is associated with an increased risk of LGA. Healthcare providers should carry out health education, and guide women to keep an ideal BMI and WC prior to pregnancy and help them gain optimal weight during pregnancy based on their pre-pregnancy BMI and WC.
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Affiliation(s)
- Xiao Gao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Yan Yan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
- * E-mail:
| | - Shiting Xiang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Guangyu Zeng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Shiping Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Tingting Sha
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Qiong He
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Hongyan Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Shan Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Cheng Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Ling Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Qiang Yan
- Department of Maternal and Child Health, Kaifu District Health Bureau, Changsha, China
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Boriboonhirunsarn D. Prevalence and risk factors for inappropriate birth weight for gestational age. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.0905.434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Background
Infants with an inappropriate birth weight for their gestational age are more likely to develop complications during pregnancy and postpartum, and have increased long-term health risks.
Objectives
To determine the prevalence and risk factors for infants with inappropriate birth weight for their gestational age.
Methods
We enrolled 820 women with uncomplicated, singleton pregnancies who gave birth to a live born infant at term. Prepregnancy baseline and obstetric information were extracted from medical records, including body mass index (BMI), gestational weight gain, and infant birth weight. Prevalence of small-for-gestational age (SGA) and large-for-gestational age (LGA) infants was determined. We compared variables between groups to identify associated factors.
Results
Prevalence of SGA was 2.6% and LGA was 10.5%. Prepregnancy BMI and gestational weight gain were significantly higher in the LGA than in the SGA group (P = 0.041 and < 0.001, respectively). The birth weight and gestational weight gain, but not the prepregnancy BMI, were significantly different (P < 0.001). Logistic regression analysis determined that inadequate gestational weight gain significantly increased the risk of SGA (adjusted OR 3.20, 95%CI 1.06 to 9.64, P = 0.039), and significantly reduced the risk of LGA (adjusted OR 0.43, 95% CI 0.20 to 0.91, P = 0.028). Excessive gestational weight gain significantly increased the risk of LGA (adjusted OR 2.00, 95% CI 1.21 to 3.30, P = 0.006). There was no significant association with prepregnancy BMI.
Conclusions
Controlling gestational weight gain may improve maternal and neonatal outcomes.
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Affiliation(s)
- Dittakarn Boriboonhirunsarn
- Department of Obstetrics and Gynaecology , Faculty of Medicine, Siriraj Hospital , Mahidol University , Bangkok 10700 , Thailand
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Associations of maternal pre-pregnancy body mass index and gestational weight gain with birth outcomes in Shanghai, China. Sci Rep 2017; 7:41073. [PMID: 28120879 PMCID: PMC5264385 DOI: 10.1038/srep41073] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 12/12/2016] [Indexed: 11/18/2022] Open
Abstract
Recent data suggests that abnormal maternal pre-pregnancy body mass index (BMI) or gestational weight gain (GWG) is associated with unfavorable delivery outcomes. However, limited clinical evidence is available to support this correlation in China. Participating 510 mother-infant pairs were recruited from the Shanghai First Maternity and Infant Hospital, China, between January 1st and 30th 2016. Maternal pre-pregnancy BMI was categorized according to the China’s classification and GWG according to the 2009 Institute of Medicine recommendations (IOM). Linear regression tested the associations between pre-pregnancy BMI or GWG and length of gestation, birthweight, length, and head circumference. Logistic regression assessed the associations between pre-pregnancy BMI or GWG and macrosomic, small- (SGA) and large- (LGA) for-gestational-age infants. Overweight/obese women showed increased length of gestation and birthweight, but did not have a higher risk of macrosomic and LGA infants compared with normal weight women. Women with excessive GWG showed increased length of gestation, birthweight, length, and head circumference, and were more likely to deliver macrosomic and LGA infants compared with women with adequate GWG. Although a relatively low proportion of women from Shanghai area are overweight/obese or exhibit excessive GWG, both high pre-pregnancy BMI and excessive GWG influence perinatal outcomes.
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Suzuki S. Optimal weight gain during twin pregnancy in Japanese women with favorable perinatal outcomes. J Matern Fetal Neonatal Med 2017; 31:119-122. [PMID: 27978777 DOI: 10.1080/14767058.2016.1272568] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We examined the optimal weight gain in the healthy Japanese women with favorable perinatal outcomes of (dichorionic) twin pregnancy. METHODS We calculated the average weight gain in the women whose height was 150-164 cm with favorable perinatal outcomes of dichorionic twin pregnancy set for this study. The women were categorized to underweight, normal, overweight and obese based on the pre-pregnancy body mass index (BMI) categories according to the Institute of Medicine (IOM) and the World Health Organization (WHO) body mass index (BMI) cutoffs. RESULTS The average GWG in the normal-weight women with the favorable perinatal outcomes was 13.9 ± 3.6 kg. It was significantly different from that in the underweight, overweight and obese women according to the both 2 BMI cutoffs by Student's t-test (p < 0.01). CONCLUSION There are optimal ranges of weight gain during twin pregnancy based on the BMI classification.
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Affiliation(s)
- Shunji Suzuki
- a Department of Obstetrics and Gynecology , Japanese Red Cross Katsushika Maternity Hospital , Tokyo , Japan
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Fukuda S, Tanaka Y, Harada K, Saruwatari A, Kitaoka K, Odani K, Aoi W, Wada S, Nishi Y, Oguni T, Asano H, Hagiwara N, Higashi A. High Maternal Age and Low Pre-Pregnancy Body Mass Index Correlate with Lower Birth Weight of Male Infants. TOHOKU J EXP MED 2017; 241:117-123. [DOI: 10.1620/tjem.241.117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Sayuri Fukuda
- Department of Food and Nutrition, Kyoto Bunkyo Junior College
| | - Yurika Tanaka
- Laboratory of Health Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University
| | - Kiyomi Harada
- School of Nursing, Kyoto Prefectural University of Medicine
| | - Ayako Saruwatari
- Laboratory of Health Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University
- Department of Food and Nutrition, Kyoto Kacho University
| | - Kaori Kitaoka
- Laboratory of Health Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University
- Department of Nutritional Science for Well-being, Faculty of Health Science for Welfare, Kansai University of Welfare Science
| | - Kiyoko Odani
- Laboratory of Health Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University
| | - Wataru Aoi
- Laboratory of Health Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University
| | - Sayori Wada
- Laboratory of Health Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University
| | - Yukari Nishi
- Division of Health Promotion, Nagaokakyo City Office
| | | | - Hiroaki Asano
- School of Nursing, Kyoto Prefectural University of Medicine
| | - Nobuko Hagiwara
- Faculty of Home Sciences and Welfare, Kyoto Notre Dame University
| | - Akane Higashi
- Laboratory of Health Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University
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Hung TH, Hsieh TT. Pregestational body mass index, gestational weight gain, and risks for adverse pregnancy outcomes among Taiwanese women: A retrospective cohort study. Taiwan J Obstet Gynecol 2016; 55:575-81. [DOI: 10.1016/j.tjog.2016.06.016] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2016] [Indexed: 01/12/2023] Open
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Fukuda S, Tanaka Y, Harada K, Saruwatari A, Kitaoka K, Odani K, Aoi W, Wada S, Oguni T, Asano H, Hagiwara N, Higashi A. Maternal Body Mass Index Correlates with the Neonatal Physique of Male Infants. TOHOKU J EXP MED 2015; 237:69-75. [PMID: 26369867 DOI: 10.1620/tjem.237.69] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Recently, in Japan, the percentage of leanness has risen in young women, and the average birth weight has decreased. An increase in the risk of low birth weight has been reported in lean expectant mothers. In this study, we aimed to clarify the relationship between mother's physique at the beginning of pregnancy and the infant's physique, by focusing on sex differences. The participants were 3,722 mothers who attended health checkups for 18-month-old infants in an urban Japanese city. The participants were limited to those with full-term births, thereby excluding the influence of gestational length. A total of 1,287 mothers, with 621 boys and 666 girls, were analyzed. Public health professionals interviewed the mothers, and transferred the required information from their maternity passbooks. We examined the physical characteristics of the mothers and their infants. Partial correlation analysis, adjusted by gestational length and the mother's age at delivery, was applied to study the association between the mother's BMI and the infant's physique at birth. In the primipara group, only the boys showed significant positive correlation between the mother's BMI and the birth weight (P = 0.025) and the Kaup index (P = 0.035). In the pluripara group, only the boys showed significant positive correlation between the mother's BMI and the head circumference (P = 0.035). Thus, mother's physique may have a stronger influence on the physique of male infants, compared to female infants. The growth-promoting effect of the mother's physique is more apparent in the infants born to the pluripara.
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Affiliation(s)
- Sayuri Fukuda
- Department of Food and Nutrition, Kyoto Bunkyo Junior College
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Li C, Liu Y, Zhang W. Joint and Independent Associations of Gestational Weight Gain and Pre-Pregnancy Body Mass Index with Outcomes of Pregnancy in Chinese Women: A Retrospective Cohort Study. PLoS One 2015; 10:e0136850. [PMID: 26313941 PMCID: PMC4552294 DOI: 10.1371/journal.pone.0136850] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 07/17/2015] [Indexed: 11/18/2022] Open
Abstract
Objective To explore the joint and independent effects of gestational weight gain (GWG) and pre-pregnancy body mass index (BMI) on pregnancy outcomes in a population of Chinese Han women and to evaluate pregnant women’s adherence to the 2009 Institute of Medicine (IOM) gestational weight gain guidelines. Methods This was a multicenter, retrospective cohort study of 48,867 primiparous women from mainland China who had a full-term singleton birth between January 1, 2011 and December 30, 2011. The independent associations of pre-pregnancy BMI, GWG and categories of combined pre-pregnancy BMI and GWG with outcomes of interest were examined using an adjusted multivariate regression model. In addition, women with pre-pregnancy hypertension were excluded from the analysis of the relationship between GWG and delivery of small-for-gestational-age (SGA) infants, and women with gestational diabetes (GDM) were excluded from the analysis of the relationship between GWG and delivery of large-for-gestational-age (LGA) infants. Results Only 36.8% of the women had a weight gain that was within the recommended range; 25% and 38.2% had weight gains that were below and above the recommended range, respectively. The contribution of GWG to the risk of adverse maternal and fetal outcomes was modest. Women with excessive GWG had an increased likelihood of gestational hypertension (adjusted OR 2.55; 95% CI = 1.92–2.80), postpartum hemorrhage (adjusted OR 1.30; 95% CI = 1.17–1.45), cesarean section (adjusted OR 1.31; 95% CI = 1.18–1.36) and delivery of an LGA infant (adjusted OR 2.1; 95% CI = 1.76–2.26) compared with women with normal weight gain. Conversely, the incidence of GDM (adjusted OR 1.64; 95% CI = 1.20–1.85) and SGA infants (adjusted OR 1.51; 95% CI = 1.32–1.72) was increased in the group of women with inadequate GWG. Moreover, in the obese women, excessive GWG was associated with an apparent increased risk of delivering an LGA infant. In the women who were underweight, poor weight gain was associated with an increased likelihood of delivering an SGA infant. After excluding the mothers with GDM or gestational hypertension, the ORs for delivery of LGA and SGA infants decreased for women with high GWG and increased for women with low GWG. Conclusions GWG above the recommended range is common in this population and is associated with multiple unfavorable outcomes independent of pre-pregnancy BMI. Obese women may benefit from avoiding weight gain above the range recommended by the 2009 IOM. Underweight women should avoid low GWG to prevent delivering an SGA infant. Pregnant women should therefore be monitored to comply with the IOM recommendations and should have a balanced weight gain that is within a range based on their pre-pregnancy BMI.
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Affiliation(s)
- Chunming Li
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Yajun Liu
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Weiyuan Zhang
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- * E-mail:
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Dell’Agnolo CM, Cyr C, de Montigny F, de Barros Carvalho MD, Pelloso SM. Pregnancy after Bariatric Surgery: Obstetric and Perinatal Outcomes and the Growth and Development of Children. Obes Surg 2015; 25:2030-9. [DOI: 10.1007/s11695-015-1668-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Relationship between maternal thyroid-stimulating hormone (TSH) elevation during pregnancy and low birth weight: a longitudinal study of apparently healthy urban Japanese women at very low risk. Early Hum Dev 2015; 91:181-5. [PMID: 25676185 DOI: 10.1016/j.earlhumdev.2014.12.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 12/09/2014] [Accepted: 12/28/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Thyroid hormones cross the placenta and promote fetal development and growth. The present study investigated whether an increase in maternal thyroid-stimulating hormone (TSH) concentration between the first and third trimesters is a determinant of birth weight during normal pregnancy. METHODS Maternal thyroid hormones and TSH were longitudinally measured at 12, 25, and 36weeks of pregnancy in 163 healthy pregnant women. Low birth weight (LBW) was defined as less than 2500g. ∆TSH12-36W was calculated as the difference in TSH concentrations between 12 and 36weeks of pregnancy. RESULTS Of the 163 neonates, 10 (6.1%) were LBW neonates. Free triiodothyronine and free thyroxine levels were similar at all gestational ages in the normal birth weight (Normal) and LBW groups. However, the median ∆TSH12-36W value was higher in the LBW than the Normal group (1.67 vs. 0.54mIU/L, P=0.008). Multivariate linear regression analysis showed that ∆TSH12-36 was inversely correlated with birth weight (β=-0.179, P=0.008). CONCLUSION An increase in maternal TSH concentration between the first and third trimesters is an independent determinant of birth weight in normal pregnancy.
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Gaudet L, Ferraro ZM, Wen SW, Walker M. Maternal obesity and occurrence of fetal macrosomia: a systematic review and meta-analysis. BIOMED RESEARCH INTERNATIONAL 2014; 2014:640291. [PMID: 25544943 PMCID: PMC4273542 DOI: 10.1155/2014/640291] [Citation(s) in RCA: 167] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 11/09/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine a precise estimate for the contribution of maternal obesity to macrosomia. DATA SOURCES The search strategy included database searches in 2011 of PubMed, Medline (In-Process & Other Non-Indexed Citations and Ovid Medline, 1950-2011), and EMBASE Classic + EMBASE. Appropriate search terms were used for each database. Reference lists of retrieved articles and review articles were cross-referenced. METHODS OF STUDY SELECTION All studies that examined the relationship between maternal obesity (BMI ≥30 kg/m(2)) (pregravid or at 1st prenatal visit) and fetal macrosomia (birth weight ≥4000 g, ≥4500 g, or ≥90th percentile) were considered for inclusion. TABULATION, INTEGRATION, AND RESULTS Data regarding the outcomes of interest and study quality were independently extracted by two reviewers. Results from the meta-analysis showed that maternal obesity is associated with fetal overgrowth, defined as birth weight ≥ 4000 g (OR 2.17, 95% CI 1.92, 2.45), birth weight ≥4500 g (OR 2.77,95% CI 2.22, 3.45), and birth weight ≥90% ile for gestational age (OR 2.42, 95% CI 2.16, 2.72). CONCLUSION Maternal obesity appears to play a significant role in the development of fetal overgrowth. There is a critical need for effective personal and public health initiatives designed to decrease prepregnancy weight and optimize gestational weight gain.
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Affiliation(s)
- Laura Gaudet
- University of Ottawa, Faculty of Medicine, 451 Smyth Road, Ottawa, ON, Canada K1H 8M5
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6
- Ottawa Hospital Research Institute, Ottawa, ON, Canada K1H 8L6
| | - Zachary M. Ferraro
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6
- Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, Canada K1H 8L1
| | - Shi Wu Wen
- Ottawa Hospital Research Institute, Ottawa, ON, Canada K1H 8L6
| | - Mark Walker
- University of Ottawa, Faculty of Medicine, 451 Smyth Road, Ottawa, ON, Canada K1H 8M5
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6
- Ottawa Hospital Research Institute, Ottawa, ON, Canada K1H 8L6
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Abstract
INTRODUCTION There is increasingly a double burden of under-nutrition and obesity in women of reproductive age. Preconception underweight or overweight, short stature and micronutrient deficiencies all contribute to excess maternal and fetal complications during pregnancy. METHODS A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on maternal, newborn and child health (MNCH) outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture. RESULTS Maternal pre-pregnancy weight is a significant factor in the preconception period with underweight contributing to a 32% higher risk of preterm birth, and obesity more than doubling the risk for preeclampsia, gestational diabetes. Overweight women are more likely to undergo a Cesarean delivery, and their newborns have higher chances of being born with a neural tube or congenital heart defect. Among nutrition-specific interventions, preconception folic acid supplementation has the strongest evidence of effect, preventing 69% of recurrent neural tube defects. Multiple micronutrient supplementation shows promise to reduce the rates of congenital anomalies and risk of preeclampsia. Although over 40% of women worldwide are anemic in the preconception period, only one study has shown a risk for low birth weight. CONCLUSION All women, but especially those who become pregnant in adolescence or have closely-spaced pregnancies (inter-pregnancy interval less than six months), require nutritional assessment and appropriate intervention in the preconception period with an emphasis on optimizing maternal body mass index and micronutrient reserves. Increasing coverage of nutrition-specific and nutrition-sensitive strategies (such as food fortification; integration of nutrition initiatives with other maternal and child health interventions; and community based platforms) is necessary among adolescent girls and women of reproductive age. The effectiveness of interventions will need to be simultaneously monitored, and form the basis for the development of improved delivery strategies and new nutritional interventions.
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Affiliation(s)
- Sohni V Dean
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
| | - Zohra S Lassi
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
| | - Ayesha M Imam
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
| | - Zulfiqar A Bhutta
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
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Abstract
The notion of preconception care aims to target the existing risks before pregnancy, whereby resources may be used to improve reproductive health and optimize knowledge before conceiving. The preconception period provides an opportunity to intervene earlier to optimize the health of potential mothers (and fathers) and to prevent harmful exposures from affecting the developing fetus. These interventions include birth spacing and preventing teenage pregnancy, promotion of contraceptive use, optimization of weight and micronutrient status, prevention and management of infectious diseases, and screening for and managing chronic conditions. Given existing interventions and the need to organize services to optimize delivery of care in a logical and effective manner, interventions are frequently co-packaged or bundled together. This paper highlights packages of preconception interventions that can be combined and co-delivered to women through various delivery channels and provides a logical framework for development of such packages in varying contexts.
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Affiliation(s)
- Zohra S Lassi
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
| | - Sohni V Dean
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
| | - Dania Mallick
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
| | - Zulfiqar A Bhutta
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
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Yachi Y, Tanaka Y, Nishibata I, Yoshizawa S, Fujihara K, Kodama S, Suzuki A, Hanyu O, Sone H. Second trimester postload glucose level as an important predictor of low birth weight infants: Tanaka Women's Clinic Study. Diabetes Res Clin Pract 2014; 105:e16-9. [PMID: 25023991 DOI: 10.1016/j.diabres.2014.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 01/09/2014] [Accepted: 02/03/2014] [Indexed: 11/30/2022]
Abstract
Although it is well known that the maternal prepregnancy BMI is a strong contributor to fetal growth, our results showed that a low postload glucose level, although within normal range, independent of maternal BMI was strongly associated with an increased risk of low birth weight births among Japanese mothers.
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Affiliation(s)
- Yoko Yachi
- Faculty of Health and Nutrition, Yamanashi Gakuin University, Yamanashi, Japan; Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Tanaka Women's Clinic, Tokyo, Japan
| | | | | | - Sakiko Yoshizawa
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Kazuya Fujihara
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Satoru Kodama
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Akiko Suzuki
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Osamu Hanyu
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Hirohito Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan.
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Evidence that birth weight is decreased by maternal lead levels below 5μg/dl in male newborns. Reprod Toxicol 2014; 47:21-6. [DOI: 10.1016/j.reprotox.2014.05.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 05/08/2014] [Accepted: 05/15/2014] [Indexed: 11/23/2022]
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Leung C, Saaid R, Pedersen L, Park F, Poon L, Hyett J. Demographic factors that can be used to predict early-onset pre-eclampsia. J Matern Fetal Neonatal Med 2014; 28:535-9. [DOI: 10.3109/14767058.2014.923837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Tanaka T, Ashihara K, Nakamura M, Kanda T, Fujita D, Yamashita Y, Terai Y, Kamegai H, Ohmichi M. Associations between the pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in Japanese women. J Obstet Gynaecol Res 2014; 40:1296-303. [PMID: 24750440 DOI: 10.1111/jog.12353] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 10/31/2013] [Indexed: 11/29/2022]
Abstract
AIM To examine the associations between the pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with pregnancy outcomes in Japanese women. METHODS The medical records of 1883 Japanese women who delivered singleton infants from January 2010 to January 2013 at Osaka-Minami Medical Center were retrospectively reviewed. We use the BMI classification which the World Health Organization defined for Asian populations and the GWG classified based on the current 2009 Institute of Medicine (IOM) recommendations. The odds ratio (OR) of each of the groups for the different pregnancy outcomes were compared to the recommended group using a logistic regression analysis adjusted by age, gestational weeks, parity, weight gain, mode of delivery, pregnancy induced hypertension (PIH) and gestational diabetes mellitus. RESULTS Women who were obese (BMI, ≥25 kg/m(2) ) and overweight (BMI, 23-24.9 kg/m(2) ) had a higher rate of developing PIH (adjusted OR, 6.68 and 3.21 [95% confidence interval [CI], 3.31-13.3 and 1.29-7.24]). In contrast, GWG exhibited a correlation with the weight of the infant. The inadequate GWG group had a higher rate of small-for-gestational age (SGA) infants (adjusted OR, 1.72 [95% CI, 1.22-2.46]). The rate of emergency cesarean section was not significantly different between the groups. CONCLUSION A pre-pregnancy BMI less than 23 kg/m(2) is desirable to prevent Japanese women from developing PIH. GWG within the IOM recommendations also reduced the risk of PIH and SGA.
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Affiliation(s)
- Tomohito Tanaka
- Department of Obstetrics and Gynecology, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Japan; Osaka Medical College, Takatsuki, Japan
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Lassi ZS, Bhutta ZA. Risk factors and interventions related to maternal and pre-pregnancy obesity, pre-diabetes and diabetes for maternal, fetal and neonatal outcomes: a systematic review. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/17474108.2013.841453] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Li N, Liu E, Guo J, Pan L, Li B, Wang P, Liu J, Wang Y, Liu G, Baccarelli AA, Hou L, Hu G. Maternal prepregnancy body mass index and gestational weight gain on pregnancy outcomes. PLoS One 2013; 8:e82310. [PMID: 24376527 PMCID: PMC3869661 DOI: 10.1371/journal.pone.0082310] [Citation(s) in RCA: 219] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 10/22/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate the single and joint associations of maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) with pregnancy outcomes in Tianjin, China. METHODS Between June 2009 and May 2011, health care records of 33,973 pregnant women were collected and their children were measured for birth weight and birth length. The independent and joint associations of prepregnancy BMI and GWG based on the Institute of Medicine (IOM) guidelines with the risks of pregnancy and neonatal outcomes were examined by using Logistic Regression. RESULTS After adjustment for all confounding factors, maternal prepregnancy BMI was positively associated with risks of gestational diabetes mellitus (GDM), pregnancy-induced hypertension, caesarean delivery, preterm delivery, large-for-gestational age infant (LGA), and macrosomia, and inversely associated with risks of small-for-gestational age infant (SGA) and low birth weight. Maternal excessive GWG was associated with increased risks of pregnancy-induced hypertension, caesarean delivery, LGA, and macrosomia, and decreased risks of preterm delivery, SGA, and low birth weight. Maternal inadequate GWG was associated with increased risks of preterm delivery and SGA, and decreased risks of LGA and macrosomia, compared with maternal adequate GWG. Women with both prepregnancy obesity and excessive GWG had 2.2-5.9 folds higher risks of GDM, pregnancy-induced hypertension, caesarean delivery, LGA, and macrosomia compared with women with normal prepregnancy BMI and adequate GWG. CONCLUSIONS Maternal prepregnancy obesity and excessive GWG were associated with greater risks of pregnancy-induced hypertension, caesarean delivery, and greater infant size at birth. Health care providers should inform women to start the pregnancy with a BMI in the normal weight category and limit their GWG to the range specified for their prepregnancy BMI.
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Affiliation(s)
- Nan Li
- Tianjin Women's and Children's Health Center, Tianjin, China
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | - Enqing Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Jia Guo
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Lei Pan
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Baojuan Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Ping Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Jin Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Yue Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Gongshu Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Andrea A. Baccarelli
- Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Lifang Hou
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Gang Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
- * E-mail:
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Morikawa M, Yamada T, Yamada T, Sato S, Cho K, Minakami H. Effects of nulliparity, maternal age, and pre-pregnancy body mass index on the development of gestational hypertension and preeclampsia. HYPERTENSION RESEARCH IN PREGNANCY 2013. [DOI: 10.14390/jsshp.1.75] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Takashi Yamada
- Center for Perinatal Medicine, Hokkaido University Hospital
| | | | - Shoji Sato
- Maternal and Perinatal Care Center, Oita Prefectural Hospital
| | - Kazutoshi Cho
- Center for Perinatal Medicine, Hokkaido University Hospital
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Mbah AK, Sharma PP, Alio AP, Fombo DW, Bruder K, Salihu HM. Previous cesarean section, gestational age at first delivery and subsequent risk of pre-eclampsia in obese mothers. Arch Gynecol Obstet 2011; 285:1375-81. [DOI: 10.1007/s00404-011-2161-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 11/23/2011] [Indexed: 10/14/2022]
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Di Benedetto A, D'anna R, Cannata ML, Giordano D, Interdonato ML, Corrado F. Effects of prepregnancy body mass index and weight gain during pregnancy on perinatal outcome in glucose-tolerant women. DIABETES & METABOLISM 2011; 38:63-7. [PMID: 21963427 DOI: 10.1016/j.diabet.2011.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 07/28/2011] [Accepted: 07/28/2011] [Indexed: 10/17/2022]
Abstract
AIM The aim of this study was to determine the effects of maternal prepregnancy body mass index (BMI) and weight gain during pregnancy on perinatal outcome in non-diabetic women. METHODS The clinical records of consecutive women who had undergone a glucose challenge test (GCT) and then delivered in our university hospital between January 2004 and December 2009 were retrospectively reviewed. Prepregnancy BMI and pregnancy weight gain were classified according to the US Institute of Medicine guidelines (1990). RESULTS Of the eligible 2225 patients, obese and overweight women had a greater percentage of macrosomic babies (17.7% and 8.9%, respectively) compared with normal weight women (4.5%). However, when considered according to weight gain during pregnancy, the results were statistically significant only for excess weight gain in the obese (OR: 8.3, 95% CI: 2.4-28.4) and overweight (OR: 2.9, 95% CI: 1.2-6.8) groups. Also, the surgical delivery rate was significantly higher in the obese vs normal weight women (56% vs 36%, respectively) although, in this case, there was no difference according to normal and excess weight gain during pregnancy (OR: 1.4, 95% CI: 0.7-2.6). CONCLUSION Overweight and obese women have an increased risk rate of macrosomia that can be limited by well-controlled weight gain during pregnancy. There was also a significantly higher rate of surgical delivery in the obese compared with the normal weight group that was, however, independent of excessive weight gain during pregnancy.
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Affiliation(s)
- A Di Benedetto
- Department of Internal Medicine, University of Messina, Messina, Italy
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Takimoto H, Sugiyama T, Nozue M, Kusama K, Fukuoka H, Kato N, Yoshiike N. Maternal antenatal body mass index gains as predictors of large-for-gestational-age infants and cesarean deliveries in Japanese singleton pregnancies. J Obstet Gynaecol Res 2011; 37:553-62. [PMID: 21375666 DOI: 10.1111/j.1447-0756.2010.01396.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM Greater antenatal weight or body mass index (BMI) gains may lead to larger fetuses and thus increase the risk for operative deliveries, such as cesarean deliveries. In order to examine the effect of weekly maternal weight and BMI changes on large-for-gestational-age (LGA) infants and cesarean delivery, delivery records from overall healthy women were analyzed. MATERIALS AND METHODS Singleton, term delivery records from January to December 2003, at three obstetric departments (urban, suburban, rural) in Japan (1617 records) were analyzed. Multivariate logistic regression analyses were applied in order to estimate the effect of maternal pre-pregnancy body size, higher maternal weight or BMI gains by calculating the odds ratios for LGA infants and cesarean deliveries. RESULTS Maternal pre-pregnancy overweight, primiparity, and BMI gains of more than 0.13 per week were independent factors positively related to LGA, and maternal underweight was negatively related. Urban hospital setting, maternal age 35 years or older, primiparity, and BMI gains of more than 0.13 per week independently increased the odds ratios for cesarean delivery. Weight or BMI gains between two-week intervals (26-28 weeks, 32-34 weeks) were not useful for predicting either LGA or cesarean delivery. LGA was unrelated to cesarean delivery risk. CONCLUSIONS Applying BMI gains per week enables target weight gains to be set according to the mother's height, which may be useful in reducing risks for LGA and cesarean delivery, especially in shorter women. Further investigation may be needed to explore the practicality and effectiveness of advising women to gain weight according to their body height.
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Affiliation(s)
- Hidemi Takimoto
- Department of Health Promotion, National Institute of Public Health, Wako-Shi, Saitama, Japan.
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Choi SK, Park IY, Shin JC. The effects of pre-pregnancy body mass index and gestational weight gain on perinatal outcomes in Korean women: a retrospective cohort study. Reprod Biol Endocrinol 2011; 9:6. [PMID: 21241516 PMCID: PMC3033321 DOI: 10.1186/1477-7827-9-6] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Accepted: 01/18/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of the study was to evaluate the effects of maternal pre-pregnancy body mass index (BMI) and gestational weight gain on perinatal outcomes in a population of Korean women. METHODS We retrospectively reviewed the medical records of 2,454 women who had received antenatal care at Seoul St. Mary's Hospital from January 2007 to December 2009. We used World Health Organization definitions for Asian populations of underweight (BMI < 18.5), normal (BMI equal or higher 18.5 and < 23), overweight (BMI equal or higher 23 and < 25), and obese (BMI equal or higher 25). We analyzed perinatal outcomes according to the pre-pregnancy BMI and weight gain during pregnancy, and calculated the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) from multiple logistic regression models by considering maternal age, parity, number of fetuses, length of gestation, and medical history. RESULTS Among obese women, the adjusted ORs for gestational diabetes, hypertensive disorder, and incompetent internal os of cervix were 4.46, 2.53, and 3.70 (95% CI = 2.63-7.59, 1.26-5.07, and 1.50-9.12), respectively, and the adjusted ORs for neonatal complications such as macrosomia and low Apgar score were 2.08 and 1.98 (95% CI = 1.34-3.22 and 1.19-3.29), respectively, compared with normal weight women. However, there was no positive linear association between gestational weight gain and obstetric outcomes. In normal weight women, maternal and neonatal complications were significantly increased with inadequate weight gain during pregnancy (p < 0.0001 and = 0.0180, respectively), and we observed similar results in underweight women (p = 0.0136 and 0.0004, respectively). CONCLUSIONS This study shows that pre-pregnancy overweight and obesity are more closely related to the adverse obstetric outcomes than excess weight gain during pregnancy. In addition, inadequate weight gain during pregnancy can result in significant complications.
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Affiliation(s)
- Sae-Kyung Choi
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, Korea
| | - In-Yang Park
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, Korea
| | - Jong-chul Shin
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, Korea
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The effect of prepregnancy body mass index on singleton cesarean delivery among term nulliparous women in Japanese population. Arch Gynecol Obstet 2010; 284:1117-22. [DOI: 10.1007/s00404-010-1812-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Accepted: 12/08/2010] [Indexed: 11/30/2022]
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Park JH, Lee BE, Park HS, Ha EH, Lee SW, Kim YJ. Association between pre-pregnancy body mass index and socioeconomic status and impact on pregnancy outcomes in Korea. J Obstet Gynaecol Res 2010; 37:138-45. [DOI: 10.1111/j.1447-0756.2010.01332.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Maternal early pregnancy body mass index and risk of preterm birth. Arch Gynecol Obstet 2010; 284:813-9. [DOI: 10.1007/s00404-010-1740-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Accepted: 10/18/2010] [Indexed: 10/18/2022]
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Watanabe H, Inoue K, Doi M, Matsumoto M, Ogasawara K, Fukuoka H, Nagai Y. Risk factors for term small for gestational age infants in women with low prepregnancy body mass index. J Obstet Gynaecol Res 2010; 36:506-12. [PMID: 20598029 DOI: 10.1111/j.1447-0756.2010.01170.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
AIM The purpose of our study was to investigate the association between low maternal prepregnancy body mass index (BMI) less than 18.5 kg/m(2) and the incidence of small for gestational age (SGA) infants. MATERIAL & METHODS This was a cross-sectional study. The women with BMI of less than 25.0 kg/m(2) who gave birth to single term infants (37-42 weeks) at clinics and hospitals in the Tokyo metropolitan area between 2003 and 2004 were analyzed for risk factors for SGA. RESULTS Five hundred and seventy-two women were underweight (BMI < 18.5 kg/m(2)) and 2708 (75.1%) were normal (18.5 <or= BMI < 25.0 kg/m(2)). Birthweight, analyzed by multiple regression analysis, was highly related (P < 0.05) to gestational age, maternal age, parity, prepregnancy BMI, maternal weight gain and maternal smoking status. Women with a less than 9 kg weight during pregnancy were 1.8 times (confidence interval [CI], 1.6-2.2) more likely to give birth to an SGA infant compared with women who gained 9-12 kg. Maternal smoking more than 10 cigarettes per day was associated with an increased risk of having an SGA infant (odds ratio [OR], 2.5; CI, 1.8-3.5). Women with prepregnancy BMI less than 21.0 kg/m(2) were associated with an increased risk of having an SGA infant (OR, 1.6; CI, 1.3-2.2 for BMI < 18.5 kg/m(2), and OR, 1.4; CI, 1.2-1.7 for 18.5 <or= BMI <or= 21.0 kg/m(2)). CONCLUSION We conclude that the detrimental effect of low prepregnancy BMI in Japanese women on birthweight and incidence of SGA infants. Our findings suggest that appropriate maternal BMI at conception followed by adequate weight gain during pregnancy may have a substantial influence on reducing the SGA infants and increasing the birthweight.
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Affiliation(s)
- Hiroko Watanabe
- Clinical Nursing, Maternity Nursing and Midwifery, Shiga University of Medical Science, Otsu, Shiga, Japan.
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Okuda M, Kunitsugu I, Yoshitake N, Hinoda Y, Suehiro Y, Okuda Y, Hobara T. Variance in the transaminase levels over the body mass index spectrum in 10- and 13-year-olds. Pediatr Int 2010; 52:813-9. [PMID: 20487366 DOI: 10.1111/j.1442-200x.2010.03167.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Transaminase levels increase with body mass index (BMI) and also with an extreme drop in the BMI, as in the case of patients with anorexia nervosa. We examined these levels over the BMI spectrum in Japanese 10- and 13-year-olds. METHODS Fifth- and eighth-grade students (n= 3747) from all schools in Shunan City, Japan, between 2006 and 2008 were included in the study. BMI z-score and serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltransferase (GGT) were measured. RESULTS The ALT and GGT levels increased with z-BMI values in the boys and 10-year-old girls (P≤ 0.001). In the 13-year-old girls, only the ALT levels increased with the z-BMI values (P= 0.018). Similarly, the proportion of subjects with elevated ALT and GGT levels increased with the z-BMI values (p(trend) < 0.05). The AST levels were negatively associated with BMI in the girls (P < 0.001). Among the boys, these levels were elevated at the highest z-BMI values and slightly elevated at lower values, but not significantly. These associations did not change after adjustments for confounders. Generalized additive model analyses revealed that transaminase had non-linear relationships with z-BMI, except for the AST levels in the girls. CONCLUSION The elevated ALT and GGT levels were associated with high BMI in both sexes. In the same study population, however, AST increased in the girls with low BMI and in the boys with high BMI.
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Affiliation(s)
- Masayuki Okuda
- Department of Environmental Safety, Yamaguchi University, Ube, Japan.
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Exactitud diagnóstica de cinco referencias gestacionales para predecir el peso insuficiente al nacer. BIOMEDICA 2010. [DOI: 10.7705/biomedica.v27i1.232] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Nishida T, Sakakibara H. Association Between Underweight and Low Lymphocyte Count as an Indicator of Malnutrition in Japanese Women. J Womens Health (Larchmt) 2010; 19:1377-83. [DOI: 10.1089/jwh.2009.1857] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Tomoko Nishida
- Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hisataka Sakakibara
- Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Rah JH, Shamim AA, Arju UT, Labrique AB, Klemm RDW, Rashid M, Christian P. Difference in ponderal growth and body composition among pregnant vs. never-pregnant adolescents varies by birth outcomes. MATERNAL AND CHILD NUTRITION 2010; 6:27-37. [PMID: 20055928 DOI: 10.1111/j.1740-8709.2009.00197.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Recently, we showed that following pregnancy and 6 months of lactation, adolescents cease linear growth and have reduced fat and lean mass in rural Bangladesh. Here, we examined whether these changes varied by pregnancy outcomes such as fetal loss, low birthweight (LBW) and neonatal mortality. Anthropometric measurements were taken among 12-19-year-old primigravidae (n = 229) in early pregnancy and at 6 months post-partum. Never-pregnant adolescents (n = 456) matched on age and time since menarche were also measured at the same time. Change in anthropometry among pregnant vs. never-pregnant adolescents was compared by pregnancy outcome adjusting for confounders using mixed effects regression models. Pregnant girls, irrespective of birth outcome, did not gain in stature, while never-pregnant girls increased in height by 0.36 +/- 0.04 cm year(-1) (P < 0.05). Body mass index, mid-upper arm circumference (MUAC) and % body fat among pregnant adolescents whose infants survived the neonatal period had decreased at 6 months post-partum, whereas those who experienced a fetal loss or neonatal death did not change in any of the measurements. Consequently, the difference in change in ponderal size and body composition measures between pregnant and never-pregnant girls was higher among those whose neonates survived vs. those who experienced a fetal loss/neonatal death (BMI: -0.64 +/- 0.11 vs. 0.01 +/- 0.16 kg m(-2) year(-1); MUAC: -0.96 +/- 0.12 vs. -0.35 +/- 0.17 cm year(-1), both P < 0.05). LBW and preterm birth did not have a similar effect modification. Linear growth ceased among pregnant girls regardless of birth outcome. Maternal weight loss and depletion of fat and lean mass at 6 months post-partum were more pronounced when the infants survived through the neonatal period.
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Affiliation(s)
- Jee H Rah
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
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Haruna M, Yeo S, Watanabe E, Matsuzaki M, Ota E, Nakayama K, Murashima S. Perceptions of women and health-care providers in Tokyo of appropriate weight gain during pregnancy. Nurs Health Sci 2010; 12:21-6. [DOI: 10.1111/j.1442-2018.2009.00478.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chen M, McNiff C, Madan J, Goodman E, Davis JM, Dammann O. Maternal obesity and neonatal Apgar scores. J Matern Fetal Neonatal Med 2010; 23:89-95. [PMID: 19670044 DOI: 10.3109/14767050903168440] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine whether maternal obesity in early pregnancy is associated with low neonatal 5-min Apgar scores while adjusting for confounders. METHODS Data were obtained from Maine State Birth Records Database. Analyses were restricted to information on 58,089 white women and their newborns. Maternal weight status was defined using the recorded early second trimester maternal body mass index (BMI) and defined as normal weight (BMI <25), overweight (BMI 25 to <30), obese (BMI 30 to <40), and morbidly obese (BMI >or=40). Logistic regression analysis was used to assess the association of maternal weight status with low Apgar score while adjusting for confounders. RESULTS Compared with newborns of normal weight women, the risk to receive low Apgar scores (4-6) is increased in newborns of obese (OR 1.4, 95% CI 1.1-1.7) and morbidly obese mothers (OR 2.0, 95% CI 1.5-2.7). The association did not achieve significance for newborns of overweight mothers (OR 1.2, 95% CI 0.99-1.4). No association was identified between maternal weight status and very low Apgar scores (0-3). CONCLUSIONS Maternal obesity is associated with a significantly increased risk for decreased Apgar scores at birth. Further studies are needed to clarify the relationships among maternal obesity, complications of pregnancy, and neonatal outcome.
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Affiliation(s)
- Minghua Chen
- Division of Newborn Medicine, Floating Hospital for Children at Tufts Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA.
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Padilha PDC, Accioly E, Veiga GVD, Bessa TC, Della Libera B, Nogueira JL, Alves PD, Souza Junior PRD, Saunders C. The performance of various anthropometric assessment methods for predicting low birth weight in pregnant women. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2009. [DOI: 10.1590/s1519-38292009000200009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES: to assess the performance of various anthropometric methods for the evaulation of the nutritional status of pregnant women as a means of predicting low birth weight (LBW). METHODS: a descriptive cross-cutting study carried out among 433 pregnant women (>20 years) attending a Public Maternity Hospital in Rio de Janeiro, Brazil. The adequacy of the weight gain at the end of the pregnancy was evaluated in accordance with the proposals of the Institute of Medicine and the Brazilian Ministry of Health. The sensitivity, specificity and accuracy of the adequacy of weight gain at the end of the pregnancy or nutritional state of mother as a predictor of low birth weight were calculated. RESULTS: the sensitivity of the various methods varied from 63.1% to 68.4% and the specificity from 71.2% to 75.1%. The adapted Institute of Medicine proposal drawn up by the Brazilian Ministry of Health, according to the classification of the pre-delivery nutritional status of the mother according to the World Health Organization cutoff points showed itself to be the most accurate (74.5%), this being the most adequate method for nutritional triage for reason of its association with low birth weight (OR=4.10; 95%CI=1.53-10.92). CONCLUSIONS: the best proposals for this population are those of the Institute of Medicine and the Brazilian Ministry of Health. Further studies aiming to ascertain the most appropriate methods of anthropometric evaluation for different populations should be encouraged.
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Torloni MR, Betrán AP, Horta BL, Nakamura MU, Atallah AN, Moron AF, Valente O. Prepregnancy BMI and the risk of gestational diabetes: a systematic review of the literature with meta-analysis. Obes Rev 2009; 10:194-203. [PMID: 19055539 DOI: 10.1111/j.1467-789x.2008.00541.x] [Citation(s) in RCA: 439] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The objective of this study is to assess and quantify the risk for gestational diabetes mellitus (GDM) according to prepregnancy maternal body mass index (BMI). The design is a systematic review of observational studies published in the last 30 years. Four electronic databases were searched for publications (1977-2007). BMI was elected as the only measure of obesity, and all diagnostic criteria for GDM were accepted. Studies with selective screening for GDM were excluded. There were no language restrictions. The methodological quality of primary studies was assessed. Some 1745 citations were screened, and 70 studies (two unpublished) involving 671 945 women were included (59 cohorts and 11 case-controls). Most studies were of high or medium quality. Compared with women with a normal BMI, the unadjusted pooled odds ratio (OR) of an underweight woman developing GDM was 0.75 (95% confidence interval [CI] 0.69 to 0.82). The OR for overweight, moderately obese and morbidly obese women were 1.97 (95% CI 1.77 to 2.19), 3.01 (95% CI 2.34 to 3.87) and 5.55 (95% CI 4.27 to 7.21) respectively. For every 1 kg m(-2) increase in BMI, the prevalence of GDM increased by 0.92% (95% CI 0.73 to 1.10). The risk of GDM is positively associated with prepregnancy BMI. This information is important when counselling women planning a pregnancy.
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Affiliation(s)
- M R Torloni
- Department of Emergency and Evidence Based Medicine, São Paulo Federal University, São Paulo, Brazil
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Arendas K, Qiu Q, Gruslin A. Obesity in pregnancy: pre-conceptional to postpartum consequences. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2008; 30:477-488. [PMID: 18611299 DOI: 10.1016/s1701-2163(16)32863-8] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To review the effects of obesity on reproduction and pregnancy outcome. METHODS A search of the literature was performed using key word searching and citation snowballing to identify English language articles published between January 1, 2000, and December 31, 2006, on the subject of obesity and its effects on pregnancy. Once the articles were identified, a thorough review of all results was conducted. Results and conclusions were compiled and summarized. RESULTS Obesity during pregnancy was linked with maternal complications ranging from effects on fertility to effects on delivery and in the postpartum period, as well as many complications affecting the fetus and newborn. The maternal complications associated with obesity included increased risks of infertility, hypertensive disorders, gestational diabetes mellitus, and delivery by Caesarean section. Fetal complications included increased risks of macrosomia, intrauterine fetal death and stillbirth, and admission to the neonatal intensive care unit. CONCLUSION Obesity causes significant complications for the mother and fetus. Interventions directed towards weight loss and prevention of excessive weight gain must begin in the pre-conception period. Obstetrical care providers must counsel their obese patients regarding the risks and complications conferred by obesity and the importance of weight loss. Maternal and fetal surveillance may need to be heightened during pregnancy; a multidisciplinary approach is useful. Women need to be informed about both maternal and fetal complications and about the measures that are necessary to optimize outcome, but the most important measure is to address the issue of weight prior to pregnancy.
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Affiliation(s)
- Kristina Arendas
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Ottawa Hospital, University of Ottawa, Ottawa ON
| | - Qing Qiu
- Chronic Disease Program, Ottawa Health Research Institute, Ottawa ON
| | - Andrée Gruslin
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Ottawa Hospital, University of Ottawa, Ottawa ON; Chronic Disease Program, Ottawa Health Research Institute, Ottawa ON
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Håkansson S, Källen K. High maternal body mass index increases the risk of neonatal early onset group B streptococcal disease. Acta Paediatr 2008; 97:1386-9. [PMID: 18647277 DOI: 10.1111/j.1651-2227.2008.00940.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to analyse the occurrence of neonatal early onset group B streptococcal (EOGBS) disease relative to maternal body mass index (BMI). METHOD A cohort of Swedish parturients with an early pregnancy BMI registered was investigated. Data were retrieved from population-based registers during 1997-2001, (n = 344 127, elective caesarean section excluded). Medical records of all infants with a diagnosis of EOGBS septicaemia (P36.0) were scrutinized for verification of the diagnosis. There were 136 cases with blood culture-positive septicaemia and 112 cases with clinical infection. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multiple logistic regression. RESULTS In obese parturients with BMI > 30, there was an 80% increased risk for verified neonatal EOGBS disease (OR 1.8, 95% CI 1.1-3.0). When cases with clinical sepsis were included a significant risk increment was also found in overweight women with BMI 25.0-29.9 (OR 1.5, 95% CI 1.1-2.0). CONCLUSION Maternal obesity and overweight are risk factors associated with increased risk of neonatal EOGBS disease.
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Affiliation(s)
- Stellan Håkansson
- Department of Pediatrics, University Hospital, SE-901 85 Umeå, Sweden.
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